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Dutch Use Computers to Find Organs for Transplant Operations

March 4, 1987

LEIDEN, Netherlands (AP) _ Dr. Bert Groenewoud and his colleagues here use a computer that rapidly matches vital organs to people awaiting transplant operations in the Netherlands, Belgium, Luxembourg, West Germany and Austria.

Groenewoud and his team play a role in about 3,800 organ transplants a year, although they rarely see the inside of an operating room.

Their Eurotransplant Foundation uses the computer to make quick matches for hearts, lungs, kidneys, livers, pancreases and corneas of people who have just died.

″Frontiers fade away,″ Groenewoud, a 34-year-old immunologist, said in an interview.

He told of arranging to get a kidney from a Russian for tranplanting into an American soldier based in West Germany.

He said he got a telephone call in 1979 from a Moscow hospital that reported it had a kidney it couldn’t place with a Soviet patient.

″It was an AB blood type - and that means you have very few recipients on your waiting list,″ Groenewoud said of the rare blood type. ″It was an excellent kidney.″

Eurotransplant’s computer found the soldier as the most suitable recipient. The kidney was flown to Leiden, examined, picked up the next day by a U.S. military aircraft and flown to a Heidelberg hospital for the transplant operation.

In its computer records, Eurotransplant lists genetic information and the blood types of patients awaiting transplants, along with how long a patient has been waiting for the operation, and how urgently he or she needs it.

Within minutes after Eurotransplant is informed of the death of a potential donor, its computer turns out a list of dozens of patients waiting transplants.

Eurotransplant looks for the recipient who shows what Groenewoud calls a ″full house″ match of genetic and blood types with the donor.

Then comes a high-tech scramble to remove the organ and get it to one of the 50 or so transplant specialty hospitals in the five-nation area.

Soaked in a nutritional fluid known as ″euro-collins,″ the organ is packed in ice and placed in a metal box and sent on its way, Groenewoud said.

Under current heart-transplant procedure, doctors have only four hours from the death of a donor to the beginning of transplant surgery. In the case of kidneys, a wait of up to two days is safe, Groenewoud said.

Two years ago, Eurotransplant rerouted a kidney to the United States that was on its way to an Austrian recipient who turned out to be inoperable.

The kidney was intercepted at Frankfurt Airport, sent on a cargo flight to Paris and flown to the United States by supersonic Concorde jet, Groenewoud said.

Patients pay a fee of $450 for Eurotransplant’s services, as part of the cost of a transplant operation, which can range up to $60,000 for a heart transplant.

The organ-matching service was founded 20 years ago to assist in the then- infant technique of kidney transplantation.

By the mid-1970s, Eurotransplant began to act as a go-between for the transplant of corneas, the transparent outer covering of the human eye.

At the beginning of this decade, Eurotransplant’s field of operations expanded to cover lungs, livers and pancreases, and overall demand increased because of the rising incidence of multiple transplants.

Last year Eurotransplant arranged heart-lung transplants for nine patients, compared to four in 1985.

Of the more conventional operations, kidney transplants are still the most numerous, with 2,485 arranged by Eurotransplant last year. Heart transplants ranked second, with 269.

But as transplant techniques improve, the waiting lists grow, according to Groenewoud, and the legal availability of organs is getting to be a problem.

Under Dutch law, a donor must carry written permission for the removal of organs, and doctors must certify that the patient is clinically dead.

Under a Belgian law soon to take effect, organs can be taken for transplant after death unless the donor has explicitly forbidden it in advance.

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